THE 50th anniversary of the first human-to-human heart transplant is an opportunity to celebrate, but South Africans should also wake up to the reality of the dire problems in cardiac health care, with “geographic injustice” rife in health-care provisioning.

That’s the view of East London cardiologist and president of the SA Society of Cardiovascular Intervention, Dr Dave Kettles. He was speaking last week at a seminar at Life St Dominic’s Hospital, organised by heart transplant recipients Ray Hartle and Ali Koekemoer.

Kettles said that while Capetonians may get transplants as state patients, in East London very few people would be treated for heart attacks, suffering substantial long-term damage as a result.

“Let’s celebrate, by all means, but let’s wake up as well to the unacceptably low standard of care offered to our population and the resultant loss of life.”

University of Cape Town and Groote Schuur Hospital cardiothoracic surgeon Dr Tim Pennel said the “cardiovascular time bomb was ticking” and he called for better co-operation between the public and private health-care sectors.

Pennel said that in the context of inadequate cardiac services, heart transplantation could not be approached in an isolated manner.

Kettles said that, based on Statistics SA mortality reports, the incidence of cardiac disease among South Africans was growing, unlike in developed countries – and many of these untimely deaths could be prevented. He called for improved detection, prevention and treatment of non-communicable diseases.

However, the country suffered because there were only 200 cardiologists to treat the total population.

In East London, a state patient could not have an angiogram or cardiac operation.

Pennel said the first transplant under Professor Chris Barnard took place in South Africa because of Barnard’s ambition and drive, the access to knowledge of cardiac research from all over the world and the expertise of the team gathered around Barnard in Cape Town.

He said that innovation was still happening in South Africa, pointing to developments around artificial replacement valves. However, the number of heart transplants had not grown. Over the 50 years, Groote Schuur had performed a total of 537 transplants, with current numbers at less than five operations a year and the transplantation programme gradually being taken over by the private sector.

The total number of heart transplants in Africa was only 18 per one million population, compared to 786 in Australia and 1 222 in the US. Less than one percent of people in Africa had access to cardiac surgery compared to 100% in the US.

Heart transplant surgeon at the Christiaan Barnard Memorial Hospital, Dr Willie Koen, said the Western diet was becoming a major problem in South Africa.

He has pioneered the use of artificial heart assist devices in South Africa, as an effective alternative to transplants.